Evaluation of anterior open-bite treatment with occlusal adjustment

Introduction: The purpose of this study was to evaluate the cephalometric and occlusal changes, the functional occlusion, and the dentinal sensitivity of anterior open-bite treatment with occlusal adjustment. Methods: The sample comprised 20 patients who experienced relapse of the anterior open bite (mean, -1.06 mm). Occlusal adjustment was performed until a positive overbite was established. Cephalometric changes were evaluated on lateral cephalograms taken before and after the occlusal adjustment. The functional occlusion analysis consisted of evaluating immediate anterior and canine guidance and the number of teeth in contact before and after the procedure. Dentinal sensitivity was evaluated before, shortly after, and 4.61 months after the occlusal adjustment. Pretreatment and posttreatment cephalometric changes and the number of teeth in contact were compared with dependent t tests. Percentages of anterior and canine guidance before and after the adjustment procedure were compared with the McNemar test. To compare dentinal sensitivity at several stages, the nonparametric Friedman test was used, followed by the Wilcoxon test. Results: Significant increases in overbite and mandibular protrusion were seen, as were significant decreases in apical base discrepancy, facial convexity, and growth pattern angles. The percentages of immediate anterior and canine guidance increased significantly, as did the number of teeth with occlusal contacts. Dentinal sensitivity increased immediately after the adjustment but decreased to normal levels after 4.61 months. Conclusions: Occlusal adjustment is a viable treatment alternative for some open-bite patients; it establishes positive vertical overbite and improves the functional occlusion with only transient dentinal sensitivity.

Petrodentine in derived dipnoan tooth plates

Most lungfish tooth plates, that are arranged in radiating ridges derived from the fusion of separate cusps in young juveniles, are based on a framework of enamel, mantle dentine and bone that encloses a mass of specialized dentines forming the occlusal surface. In most taxa, the specialized dentines are interdenteonal and circumdenteonal dentine, but a few derived genera have petrodentine as well. Petrodentine, as originally defined, describes a specific form of hypermineralized dentine in adult tooth plates of the Recent African lungfish Protopterus. The ontogeny of fossil and Recent lungfish tooth plates demonstrates that petrodentine is derived by continuous enhancement of the hard tissue of the primary core of the initially isolated cusps of the tooth plate, and that interdenteonal dentine with denteons of circumdenteonal dentine is a secondary development in the tooth plate around and below the first formed cusps of the ridges. In dipnoans that lack petrodentine in adults the primary core of the cusps is not enhanced, but is removed by wear. The hard tissues of the dipnoan tooth plate provide useful characters for defining dipnoan taxa, as do the differing arrangements of the tissues in each species. Details of the arrangement of the enclosed specialized dentines are surprisingly variable among genera, and are significant for the structure and function of the tooth plate. Little regularity of structure is discernible in the histology of tooth plates of early dipnoans, but derived genera have more predictable structure. Consistent with other uniquely dipnoan characters, like the composition of the dermal skull, an evolutionary progression is evident within the group in the fine structure of the dentition, and, as with the bones of the dermal skull, little similarity is demonstrable between the dentines of dipnoans and tetrapods.

Consequences of traumatic injury in fossil and recent dipnoan dentitions

Traumatic injury to the dentition of dipnoans, indirectly as a result of jaw fracture, or directly from damage to the tooth tissues, is present throughout the history of this group, in fossil and in Recent material. Bones heal, but traces of the injury are retained in the tooth tissues, permanently if the proliferative regions of the tooth plate are injured, or until the damaged dentines are removed by wear if the growing regions are left intact. Lack of resorption and repair of damaged dental hard tissues in dipnoans has implications for some models of tooth plate growth in lungfish with a permanent dentition, because this indicates that lungfish tooth plates may not have the capacity to form reparative dentine as part of the normal growth processes.

Progressive recovery of osseoperception as a function of the combination of implant-supported prostheses

The extraction of teeth involves the elimination of extremely sensitive periodontal mechanoreceptors, which play an important role in oral sensory perception. Objectives: The aim of this study was to evaluate the recovery of interocclusal sensory perception for micro-thickness in individuals with different types of implant-supported prostheses. Materials and Methods: Wearers of complete dentures (CDs) comprised the negative control group (group A, n=17). The experimental group consisted of wearers of prostheses supported by osseointegrated implants (Group B, n=29), which was subsequently divided into 4 subgroups: B(1) (n=5) - implant supported overdentures (ISO) occluding with CD; B(2) (n=6) - implant-supported fixed prostheses (ISFP) occluding with CD; B3 (n=8) - wearers of maxillary and mandibular ISFP, and B(4) (n=10) - ISFP occluding with natural dentition (ND). Individuals with ND represented the positive control group (Group C, n=24). Aluminum foils measuring 10 mu m, 24 mu m, 30 mu m, 50 mu m, 80 mu m, and 104 mu m thickness were placed within the premolar area, adding up to 120 tests for each individual. Results: The mean tactile thresholds of groups A, B(1), B(2), B(3), B(4), and C were 92 mu m, 27 mu m, 27 mu m, 14 mu m, 10 mu m, and 10 mu m, respectively. [Correction added after publication online 18 April 2008: in the preceding sentence 92 mu m, 27 mu m, 14 mu m, 10 mu m and 10 mu m, was corrected to 92 mu m, 27 mu m, 27 mu m, 14 mu m, 10 mu m and 10 mu m.] The Kruskal-Wallis test revealed significant difference among groups (P < 0.05). The Dunn test revealed that group A was statistically different from groups C, B(3), and B(4), and that B(1) and B(2) were statistically different from group C. Conclusion: Progressive recovery of osseoperception as a function of the combination of implant-supported prostheses could be observed. Moreover, ISO and/or ISFP combinations may similarly maximize the recovery of osseoperception.

Long-term stability of surgical-orthodontic open-bite correction

Introduction: The objective of this study was to evaluate the long-term stability of open-bite surgical-orthodontic correction. Methods: Thirty-nine patients at an initial mean age of 20.83 years were evaluated cephalometrically at pretreatment (T1), immediately after treatment (T2), and at the last recall (T3), with a mean follow-up time of 8.22 years. The surgical protocol included single-jaw or double-jaw surgery. Because the patients had different anteroposterior malocclusions, the sample was divided into a Class I and Class II (I-II) subgroup (3 Class I, 20 Class II malocclusion patients) and a Class III subgroup (16 patients). The dentoskeletal characteristics of the total sample and the subgroups were compared at T1, T2, and T3 with dependent analysis of variance (ANOVA). Results: Overbite relapse in the posttreatment period was statistically significant in the whole sample and the Class I-II subgroup. Fourteen patients of the whole sample (35.9%) had clinically significant open-bite relapse (negative overbite). Conclusions: There was a statistically significant open-bite relapse in the overall sample and in the Class I-II subgroup. The clinically significant values of long-term open-bite correction stability were 64.11%, 47.82%, and 87.50% in the overall sample, the Class I-II subgroup, and the Class III subgroup, respectively. (Am J Orthod Dentofacial Orthop 2010;138:254.e1-254.e10)

Evaluation of distances between the mandibular teeth and the alveolar process in Brazilians with normal occlusion

Introduction: The aims of this study were to evaluate the distances between the mandibular permanent teeth and the alveolar process in Brazilians with normal occlusion and to compare them with normal American values. Methods: We used 59 mandibular casts from untreated subjects who had permanent dentition and the 6 keys to normal occlusion. A computer program was used to calculate the distances between the dental reference points and the alveolar process for each tooth. The mean values were then compared to the normal values by applying the Student t test at a significance level of 0.05. Results: The results showed a progressive increase of these distances from the anterior region (incisors) to the posterior region (molars), from 0.00 to 2.49 mm. All measurements had statistically significant differences from the American sample, except for the values for canines and first premolars. Conclusions: Brazilians with normal occlusion have more lingual crown positions for the incisors, second premolars, and molars compared with Americans with normal occlusion. Although these findings were statistically significant, they are unlikely to be clinically significant. (Am J Orthod Dentofacial Orthop 2010; 137: 308.e1-308.e4)

Association between breastfeeding duration and non-nutritive sucking habits

Objective To evaluate the relationship between breastfeeding duration and the prevalence of non-nutritive Sucking habits in children with deciduous dentition. Method A cross-sectional survey was conducted on the mothers of 551 children aged 3 to 6 years, randomly selected from public pre-schools in Sao Paulo, Brazil. Mothers were asked to complete a questionnaire that included items regarding their children`s age, gender, race, method and duration of infant feeding, as well as pacifier use and/or digit-sucking habits. According to the answers pertinent to the method and duration of infant feeding, children were assigned to five groups: 1 - never breastfed, 2 - breastfed for a period shorter than 3 months of life, 3 - breastfed for 3 to 6 months, 4 - breastfed for 6 to 9 months, and 5 - breastfed for 9 months or longer. Data were submitted to the Fisher`s exact test with Bonferroni correction for multiple comparisons to analyse possible associations between breastfeeding duration period categories and non-nutritive sucking behaviours. Results Pacifier use frequency was high in groups 1, 2, 3 and 4 (85%, 87.6%, 78% and 70%, respectively), in comparison with that in group 5 (38.6%). The prevalence of non-nutritive sucking habits was significantly reduced in children who were breastfed for nine months or longer (p=0.000). There were no statistically significant differences in the frequencies of pacifier use and/or digit-sucking habits between genders, regardless of the breastfeeding duration period. Conclusion Children aged 3-6 years who were breastfed for nine months or longer had a lower prevalence of non-nutritive sucking habits.

The role of dentists in-diagnosing osteogenesis imperfecta in patients with dentinogenesis imperfecta

Background. Osteogenesis imperfecta (OI), also known as ""brittle bone disease,"" can be difficult to diagnose in its mild form. The authors describe a clinical case of a diagnosis of dentinogenesis imperfecta (DI), In which a literature review combined with an analysis of dental alterations led to indications of OI involvement. Case Description. Since DI can be associated with OI, the authors reviewed correlated studies and obtained a new medical history from the patient. They then conducted a radiographic and clinical examination of the dentition and submitted an affected third molar to scanning electron microscopy analysis. They compared their findings with descriptions of OI type I dental alterations in the literature and confirmed their diagnosis by means of a medical evaluation. Clinical Implications. In cases in which DI is diagnosed, patients should be examined carefully and the occurrence of OI should be considered `since, in its mild form, it might be misdiagnosed.

Clinical management and subsequent healing of teeth with horizontal root fractures

Horizontal root fractures are uncommon, mainly occurring on the cervical and middle third of the root of permanent upper incisors. The diagnosis is essentially radiographic and requires different healing patterns, depending on some pre- and postinjury factors. The aim of this article was to report the clinical management and different healing types in three cases of horizontal root fractures on permanent dentition. In case 1, the pulp tissue was vital and no treatment was necessary. In case 2, a root canal treatment of the cervical fragment was necessary and in case 3, pulpal necrosis was verified and an apical surgery was performed.

Distribution of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in an Australian population

Background, aim: The present study describes (i) the natural distribution of the three putative periodontopathogens Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans in an Australian population and (ii) the relationship between these organisms, pocket depths and supragingival plaque scores. Methods: Subgingival plaque was collected from the shallowest and deepest probing site in each sextant of the dentition. In total, 6030 subgingival plaque samples were collected from 504 subjects. An ELISA utilising pathogen-specific monoclonal antibodies was used to quantitate bacterial numbers. Results:: A. actinomycetemcomitans was the most frequently detected organism (22.8% of subjects) followed by P. gingivalis and P. intermedia (14.7% and 9.5% of subjects respectively). The majority of infected subjects (83%) were colonised by a single species of organism. A. actinomyceteincomitans presence was overrepresented in the youngest age group but under-represented in the older age groups. Conversely, P. gingivalis and P. intermedia presence was under-represented in the youngest age group but over-represented in the older age groups. Differing trends in the distribution of these bacteria were observed between subjects depending upon the site of the infection or whether a single or mixed infection was present; however, these differences did not reach significance. Bacterial presence was strongly associated with pocket depth for both A. actinomyceteincomitans and P. gingivalis. For A. actinomycetemcomitans, the odds of a site containing this bacterium decrease with deeper pockets. In contrast, for P. gingivalis the odds of a site being positive are almost six times greater for pockets >3 ram than for pockets less than or equal to3 nun. These odds increase further to 15.3 for pockets deeper than 5 mm. The odds of a site being P. intermedia positive were marginally greater (1.16) for pockets deeper than 3 mm. Conclusions: This cross-sectional study in a volunteer Australian population, demonstrated recognised periodontal pathogens occur as part of the flora of the subgingival plaque. Prospective longitudinal studies are needed to examine the positive relationship between pocket depth and pathogen presence with periodontal disease initiation and/or progression.

Neoechinorhynchus ningalooensis sp nov (Acanthocephala : Neoechinorhynchidae) from Scarus ghobban and S. psittacus (Scaridae) from Western Australia

Neoechinorhynchus ningalooensis sp. nov, is described from Scarus ghobban Forsskal, 1775 and S. psittacus Forsskal, 1775 (Scaridae) from Ningaloo Reef, Western Australia. The new species is distinguished by having a combination of the Following: three circles of six hooks on the proboscis; anterior hooks equal in size (66-68 (Im long), middle hooks (50-58 mum long), 79% smaller than anterior hooks, posterior hooks (40-44 mum long) smallest; lemnisci equal in length and extending beyond the proboscis receptacle but not to ovoid testes; terminal papilla absent. This report is the first published account of an acanthocephalan from parrotfish (Scaridae) and the first record of an eoacanthocephalan from the western coast of Australia.

Hyaline tissue of thermally unaltered conodont elements and the enamel of vertebrates

Comparison of the ultrastructure of the hyaline tissue of conodont elements and the enamel of vertebrates provides little support for a close phylogenetic relationship between conodonts and vertebrates. Transmission and scanning electron microscopy shows that the mineralised component of the hyaline tissue of Panderodus and of Cordylodus elements consists of large, flat, oblong crystals, arranged in layers that run parallel to the long axis of the conodont. Enamel in the dentition of a living vertebrate, the lungfish Neoceratodus forsteri, has crystals of calcium hydroxyapatite, arranged in layers, and extending in groups from the dentine-enamel junction; the crystals are slender, elongate spicules perpendicular to the surface of the tooth plate, Similar crystal arrangements to those of lungfish are found in other vertebrates, but none resembles the organisation of the hyaline tissue of conodont elements, The crystals of hydroxyapatite in conodont hyaline tissue are exceptionally large, perpendicular or parallel to the surface of the element, with no trace of prisms, unlike the protoprismatic radial crystallite enamel of fish teeth and scales, or the highly organised prismatic enamel of mammals.

Dental erosion patterns from intrinsic acid regurgitation and vomiting

Background: The distribution of lesions from dental erosion due to intrinsic acid regurgitation and vomiting may be different from patterns of dental erosion due to extrinsic acids. To date studies have failed to validate this assumption. This study described the sites and nature of lesions from dental erosion in cases of intrinsic acid regurgitation, and compared them with the distribution of lesions occurring in age and sex matched controls, whose lesions are due to extrinsic acids. Methods: The University of Queensland tooth wear clinic patients were screened to select 30 cases, 21 self-identified bulimics and nine medically diagnosed chronic gastric acid regurgitators, and 30 controls. Epoxy resin models of the subjects' dentition were examined under stereoscopic light microscope at magnification 16 to 40. The patterns and sites of tooth wear were recorded for teeth representative of 20 tooth sites in every subject. Results: While the incisal edges of maxillary and mandibular anterior teeth of acid regurgitators were more frequently affected by erosion, incisal attrition was more common on controls' teeth. Cervical lesions were more commonly found in association with incisal attrition in the controls, and in association with incisal erosion in the cases. In 10 per cent of sites in case subjects, cervical lesions associated with incisal erosion were found on the lingual aspects of their mandibular incisors, canines and premolars. These lesions were almost exclusive to the case subjects. Conclusions: These results validate that lingual cervical lesions associated with incisal erosion on the mandibular anterior teeth are strong discriminators between tooth wear in patients with bulimia nervosa or chronic gastro-oesophageal reflux and those whose dental erosion is due to extrinsic acids.

A survey of dental and oral trauma in south-east Queensland during 1998

Background: This project investigated the aetiology of dental and oral trauma in a population in southeast Queensland. The literature shows there is a lack of dental trauma studies which are representative of the general Australian population. Method: Twelve suburbs in the south-east district of Queensland were randomly selected according to population density in these suburbs for each 25th percentile. All dental clinics in these suburbs were eligible to participate. Patients presenting with dental and oral trauma were eligible to participate. Results: A total of 197 patients presented with dental/oral trauma over a 12 month period. The age of patients ranged from 1-64 years whilst the most frequently presenting age group was 6-10 years. There was a total of 363 injured teeth with an average of 1.8 injured teeth per patient. Males significantly outnumbered females in the incidence of trauma. Conclusions: The highest frequency of trauma occurred in the 6-10 year age group. Most injuries in this group occurred while playing or riding bicycles. In the next most prevalent trauma group, 16-20 years, trauma occurred as a result of fighting and playing sport. Overall, males significantly outnumbered females by approximately 1.8:1.0. The majority of injuries in the deciduous dentition were to periodontal tissues. In the secondary dentition most injuries were to hard dental tissue and pulp.

Diagnosis and management of unusual dental abscesses in children

Although the majority of dental abscesses in children originate from dental caries or trauma, a few are associated with unusual conditions which challenge diagnosis and management. Recent research findings have shed light on these unusual entities and greatly improved understanding of their clinical implications. These conditions include developmental abnormalities such as dens invaginatus in which there is an invagination of dental tissues into the pulp chamber and dens evaginatus in which a tubercle containing pulp is found on the external surface of a tooth crown. In addition, inherited conditions which show abnormal dentine such as dentine dysplasia, dentinogenesis imperfecta, and osteogenesis imperfecta predispose the dentition to abscess formation. Furthermore, 'spontaneous' dental abscesses are frequently encountered in familial hypophosphataemia, also known as vitamin D-resistant rickets, in which there is hypomineralization of dentine and enlargement of the pulp. In addition to developmental conditions, there are also acquired conditions which may cause unusual dental abscesses,. These include pre-eruptive intracoronal resorption which was previously known as 'pre-eruptive caries' or the 'fluoride bomb'. In addition, some undiagnosed infections associated with developing teeth are now thought to be the mandibular infected buccal cysts which originate from infection of the developing dental follicles. In the present paper, these relatively unknown entities Which cause unusual abscesses in children are reviewed with the aim of updating the general practitioner in their diagnosis and management.